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The great imitator--still today! A case of meningovascular syphilis affecting the posterior circulation

Jochen Bäuerle1, Anna Zitzmann1, Karl Egger2

  • 1Department of Neurology, University Hospital Freiburg, Freiburg, Germany.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 6, 2014
PubMed

Insights

Meningovascular syphilis, a rare cause of stroke, can affect the posterior circulation, leading to conditions like Parinaud syndrome. Early diagnosis is crucial for effective treatment of this syphilitic brain infarction.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Neurology

Background:

  • Meningovascular syphilis is an uncommon cause of cerebral ischemia.
  • It typically affects the anterior circulation more than the posterior circulation.

Observation:

  • A 50-year-old patient presented with Parinaud syndrome and dorsal midbrain infarction.
  • Brain MRI revealed vasculitis affecting the posterior circulation.

Findings:

  • Serum and cerebrospinal fluid tests confirmed meningovascular syphilis.
  • The patient's stroke was attributed to syphilitic infection of brain blood vessels.

Implications:

  • Clinicians should consider meningovascular syphilis in stroke differentials, especially in young males with cryptogenic strokes.
  • Awareness of this rare condition is vital for appropriate and timely treatment, significantly impacting patient outcomes.
Keywords:
MRIMeningovascular syphilisstrokevasculitis

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